Early detection of people with undiagnosed type 2 diabetes (T2D) is an important public health concern. Several predictive equations for T2D have been proposed but most of them have not been ...externally validated and their performance could be compromised when clinical data is used. Clinical practice guidelines increasingly incorporate T2D risk prediction models as they support clinical decision making. The aims of this study were to systematically review prediction scores for T2D and to analyze the agreement between these risk scores in a large cross-sectional study of white western European workers. A systematic review of the PubMed, CINAHL, and EMBASE databases and a cross-sectional study in 59,042 Spanish workers was performed. Agreement between scores classifying participants as high risk was evaluated using the kappa statistic. The systematic review of 26 predictive models highlights a great heterogeneity in the risk predictors; there is a poor level of reporting, and most of them have not been externally validated. Regarding the agreement between risk scores, the DETECT-2 risk score scale classified 14.1% of subjects as high-risk, FINDRISC score 20.8%, Cambridge score 19.8%, the AUSDRISK score 26.4%, the EGAD study 30.3%, the Hisayama study 30.9%, the ARIC score 6.3%, and the ITD score 3.1%. The lowest agreement was observed between the ITD and the NUDS study derived score (κ = 0.067). Differences in diabetes incidence, prevalence, and weight of risk factors seem to account for the agreement differences between scores. A better agreement between the multi-ethnic derivate score (DETECT-2) and European derivate scores was observed. Risk models should be designed using more easily identifiable and reproducible health data in clinical practice.
Background: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve ...into the impact of healthy habits on diabesity. Methods: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student’s t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer–Lemeshow goodness-of-fit test was also performed. Results: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3–0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2–8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. Conclusions: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.
This study tests the relationships between workaholism (i.e. working excessively and compulsively), sleep problems and cardiovascular risk in 537 employees from five Spanish hospitals. Four types of ...worker (i.e. workaholics, positive workers, compulsive workers and hard workers) were distinguished, and their health indicators were compared. The results showed that workaholics experienced significantly more sleep problems (i.e. morning tiredness, sleeping while driving and sleeping fewer hours both on weekdays and at weekends, with poorer quality), had higher relative risk scores, and consumed more caffeine and alcohol than the other patterns of worker (positive, compulsive and hard workers). Further analyses revealed that sleep problems fully mediated the relationship between workaholism (i.e. working excessively and compulsively) and cardiovascular risk. The study emphasizes the fact that being a workaholic might be a significant risk factor for having sleep problems and cardiovascular disease.
This study was designed to evaluate the relationship between urinary phytate concentration and risk of fracture at
10 years, determined by using the FRAX model, in women who had undergone menopause ...within 5 years of the time of enrollment.
Of the 212 postmenopausal women evaluated, 69 were excluded because they had urinary phytate concentrations
between 0.51 and 0.99 mg/L. Of the remaining 143 women, 91 had low (≤0.50 mg/L) and 52 had high (≥1.0 mg/L) urinary phytate
concentrations. The 10-year risk of fracture was calculated by using the FRAX model.
The risks of major osteoporotic fracture and hip fracture were higher in women with low urinary phytate levels (P < 0.001 in
both cases). Evaluation of the risk of hip fracture in women with and without risk factors for osteoporosis (e.g., tobacco, alcohol, and
drug consumption) and according to urinary phytate concentrations indicated that, among women with no risk factors, those with low
and high urinary phytate levels had a range of risks of 0%–0.6% and 0%–0.3%, respectively (P = 0.098). Moreover, among women with at
least one risk factor, those with low and high urinary phytate had a range of risks of 0.1%–0.8% and 0.1%–0.4%, respectively (P = 0.002).
Similar results were observed when the risks of major osteoporotic fracture were analyzed.
These results indicate the relationship of phytate with the risks of major osteoporotic fracture and hip fracture, with these
differences being more marked in women with risk factors for osteoporosis. From this study follows the importance of the consumption
of phytate-rich products (nuts, legumes, whole cereals) to protect against the risk of fracture in 10 years, mainly in women with risk
factors for osteoporosis.
Aims
To test whether communicating cardiovascular diseases (CVD) risk using a novel risk assessment tool (Heart Age) will be able to motivate a population to adopt healthier lifestyles and improve ...CVD risk profile over the use of a traditional percentage-based tool.
Methods
A single-blind randomized intervention study was carried out in a Caucasian population. A total of 3153 subjects were randomly allocated to one of three study groups: control (conventional medical advice was given to the subjects), Framingham REGICOR (10-year percentage risk score, calibrated to Spanish population was given to the subjects), or Heart Age group (Heart Age tool was administered to the subjects). Anthropometrical and metabolic parameters were measured and lifestyle habits were recorded at recruitment and 12-months post intervention.
Results
Both the Framingham REGICOR and the Heart Age intervention groups demonstrated significant decreases in their risk scores at post intervention compared to the control group, with the improvement being of a greater magnitude in the Heart Age group. No differences per gender were observed in the Heart Age group.
Conclusions
Informing patients about their CVD risk expressed as the new Heart Age tool results in a reduction in their CVD risk higher than the one observed when the Framingham REGICOR risk score was used.
Several studies have shown a relation between the adipose tissue accumulation and a higher risk for developing metabolic and cardiovascular diseases. Thus, body fat content and, mainly, the fat ...distribution or adiposity could be considered as important indicators of health risk. In spite of presenting several limitations, BMI is the most widely used and accepted index for classifying overweight and obesity. The aim of the study was to evaluate the correlations between Body Adiposity Index (BAI), BMI and other adiposity indexes such as WC, WHR and WHtR with cardiovascular and metabolic risk factors. Furthermore, the behavior of BAI and BMI regarding the ability to discriminate overweight or obese individuals was also analyzed.
A cross-sectional study was conducted in Spanish Caucasian adult workers. Participants in the study (29.214 men and 21.040 women, aged 20-68 years) were systematically selected during their work health periodic examinations. BAI, BMI, WHR, WHtR, body weight, hip and waist circumference (WC) as well as systolic and diastolic blood pressure were measured. Serum levels of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and glucose were also determined. Results of the study indicated that BAI was less correlated with cardiovascular risk factors and metabolic risk factors than other adiposity indexes (BMI, WC and WHtR). The best correlations were found for WHtR. In addition, the BAI presented lower discriminatory capacity than BMI for diagnosing metabolic syndrome (MS) using both IDF and ATP III criteria. A different behavior of the BAI in men and women when considering the ability to discriminate overweight or obese individuals was also observed.
The adiposity indexes that include the waist circumference (WHtR and WC) may be better candidates than BAI and BMI to evaluate metabolic and cardiovascular risk in both clinical practice and research.
Atherogenic indices predict cardiovascular disease, as they provide a good reflection of the clinical and metabolic interactions of lipid fractions.
A descriptive cross-sectional study was conducted ...on 60,798 workers in the Spanish Mediterranean area on whom different atherogenic indices (cholesterol/HDL, LDL/HDL, triglycerides/HDL) were determined, and the influence they have in the different productive work sectors.
In women, the mean values of the different atherogenic indices are better in the health sector, while they are better in men in the primary sector. The percentage of working women with low values is also greater in the healthcare sector, while in men there is no clear predominant sector, with the best values being shown in the hospitality and primary sector.
The distribution of cardiovascular risk factors and the values of the different atherogenic indices analyzed vary in different industrial sectors.
To describe the cardiovascular risk factors in a working population in the Balearic Islands and to examine whether differences by social class vary according to age and gender.
A cross-sectional ...study was carried out in a sample of active workers aged 20-65 years in the Balearic Islands. The participants were included in the study during their annual work health assessment in 2011. The following variables were collected: occupation, social class, age, gender, height, weight, smoking, blood pressure, lipid profile, and glucose levels. Cardiovascular risk was calculated using two different equations (Framingham and REGICOR).
Differences by social class were observed for most cardiovascular risk factors. The pattern of these differences differed depending on age group and gender. Differences in obesity by social class increased with age in women but decreased in men. More differences in hypertension by social class were found among women than among men, with differences increasing with age in both genders. Significant differences by social class were found among women in lipid profile, and these differences increased with age, mainly for low levels of high-density lipoprotein-cholesterol.
Inequalities in cardiovascular risk factors by social class were higher among women than among men. Some cardiovascular risk factors such as smoking and obesity showed significant inequalities from a very early age.
the prevalence of cardiovascular risk factors is well known in the general population. The aim of our study is to determine the prevalence of unknown major cardiovascular risk factors, in an ...apparently healthy Balearic working population.
data were obtained to 3,035 people randomly selected and with unknown previous diagnosis of hypertension, diabetes or hypercholesterolemia. To compare proportions we used the χ2 test and the t-Student test for comparison of means.
the prevalence of unknown hypertension in men was 20.6%, hypercholesterolemia 11.6%and 2.6% diabetes. The prevalence of unknown hypertension, hypercholesterolemia and diabetes in women were 8.3,5.4 and 0.8%, respectively. All cardiovascular risk factors except low HDL-cholesterol were more prevalent in men. 14.4%of men and 5.5% of women met metabolic syndrome.
there is a very high prevalence of cardiovascular risk factors in the working population considered theoretically healthy. This highlights the important role in this field from the occupational health units to make them emerge.
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